背景:追究或拒绝刑事指控的检察官自由裁量权是确定使用毒品(PWUD)的人的刑事司法结果的强大机制。在美国,检察官越来越多地使用这种工具来防止逮捕,监禁,以及随后的健康和社会危害。许多人将减少伤害作为这些改革的基础;然而,检察官对减少伤害原则的了解和理解程度,以及它们如何在政策过程中运作,尚不清楚。
方法:我们评估了在14个美国司法管辖区的检察药物政策改革的政策设计和实施过程中减少危害的参考和应用。从2021年11月至2022年4月,对当选的检察官及其政策人员进行了深入访谈(N=16)。通过最初的结构化分析,政策制定者对“减少伤害”一词的理解和利用成为一个突出的主题,我们进行了二次主题分析以进一步探讨。
结果:虽然所有参与者都被认为是进步的,他们的意识形态差异很大,政策规定,并参与减少伤害的原则。11名参与者明确提到“减少吸毒危害”或“减少危害”作为其政策方法的指导;其余的人没有引用“减少危害”的名称,但强调了诸如种族平等和“公共卫生方法”之类的相关概念作为核心政策原则。虽然一些检察官表现出对传统的减少伤害原则的熟悉(符合PWUD的要求,减少对他们的伤害),其他人专注于对更广泛的社区的伤害(公众,\'企业,etc).援引减少伤害并不总是符合具体的政策规定:检察官实施了从无条件不起诉持有毒品到转移毒品,其中一些与尊严和正义的核心减少伤害原则(即,涉及强制性待遇激励/要求)。
结论:随着检察官改变其方法来纠正毒品定罪所造成的危害,需要澄清使用酌处权的减少伤害方法需要什么。针对具有改革意识的检察官,传达有关原则的信息,证据基础,减少伤害的最佳做法是值得的。
BACKGROUND: Prosecutorial discretion to pursue or decline criminal charges is a powerful mechanism determining criminal justice outcomes among people who use drugs (PWUD). In the US, prosecutors are increasingly employing this tool to prevent arrest, incarceration, and subsequent health and social harms among PWUD. Many cite harm reduction as a basis for these reforms; however, the extent of prosecutors\' knowledge and understanding of harm reduction principles, and how they are operationalized in the policy process, remains unclear.
METHODS: We assess references to and application of harm reduction in the policy design and implementation process of prosecutorial drug policy reform in 14 US jurisdictions. In-depth-interviews (N = 16) were conducted with elected prosecutors and their policy staff from November 2021-April 2022. Through initial structured analysis, policymakers\' understanding and utilization of the term \'harm reduction\' emerged as a salient theme which we conducted secondary thematic analysis to further explore.
RESULTS: While all participants identified as progressive, there was wide variation in their ideologies, policy provisions, and engagement with harm reduction principles. Eleven participants explicitly referred to \'reducing harms of drug use\' or \'harm reduction\' as guiding their policy approach; the remainder did not invoke \'harm reduction\' by name but highlighted relevant concepts like racial equity and \'public health approaches\' as core policy tenets. While some prosecutors demonstrated familiarity with traditional harm reduction principles (meeting PWUD where they are, reducing harms to them), others focused on harm to the wider community (the \'public,\' businesses, etc). Invocation of harm reduction was not always consistent with specific policy provisions: prosecutors implemented policies ranging from unconditional non-prosecution of drug possession to diversion, some of which were odds with core harm reduction principles of dignity and justice (i.e., involving coercive treatment incentives/requirements).
CONCLUSIONS: As prosecutors shift their approach to redress the harms caused by drug criminalization, clarity is needed on what a harm reduction approach to using discretionary powers entails. Targeting reform-minded prosecutors with messaging on the principles, evidence base, and best practices of harm reduction is merited.